Augmented Reality-Guided Extraction of Fully Impacted Lower Third Molars Based on Maxillofacial CBCT Scans.

(1) Background: This study aimed to integrate an augmented reality (AR) image-guided surgery (IGS) system, based on preoperative cone beam computed tomography (CBCT) scans, into clinical practice. (2) Methods: In preclinical and clinical surgical setups, an AR-guided visualization system based on Microsoft's HoloLens 2 was assessed for complex lower third molar (LTM) extractions. In this study, the system's potential intraoperative feasibility and usability is described first. Preparation and operating times for each procedure were measured, as well as the system's usability, using the System Usability Scale (SUS). (3) Results: A total of six LTMs (n = 6) were analyzed, two extracted from human cadaver head specimens (n = 2) and four from clinical patients (n = 4). The average preparation time was 166 ± 44 s, while the operation time averaged 21 ± 5.9 min. The overall mean SUS score was 79.1 ± 9.3. When analyzed separately, the usability score categorized the AR-guidance system as "good" in clinical patients and "best imaginable" in human cadaver head procedures. (4) Conclusions: This translational study analyzed the first successful and functionally stable application of the HoloLens technology for complex LTM extraction in clinical patients. Further research is needed to refine the technology's integration into clinical practice to improve patient outcomes.

Nuclear imaging to visualize periodontal inflammation: Findings of a randomized controlled trial.

OBJECTIVE: To investigate non-surgical periodontal therapy by 18F-fluorodeoxyglucose (2-[18 F]FDG) uptake using positron emission tomography (PET) integrated with computed tomography (CT). SUBJECTS: Eighty-five patients with peripheral artery disease and severe periodontitis-randomized into three groups receiving therapy with (PT1; n = 29) or without (PT2; n = 28) systemic antibiotics or no treatment (controls: n = 28)-underwent nuclear imaging at baseline and at 3 months. RESULTS: Clinical inflammation (periodontal inflamed surface area; PISA) did not significantly differ across the groups at baseline (p = 0.395) but was significantly reduced at 3 months (p < 0.001), and significantly more so in the PT1/PT2 groups than in the control group (p < 0.001/=0.025) and in the PT1 than in the P2 group (p = 0.001). Radiotracer uptake was measured in both jaws using maximum and mean 'standardized uptake values' (SUVmax , SUVmean ) and 'target-to-background ratios' (TBRmax , TBRmean ). At 3 months, reductions were relatively small in absolute numbers and fell short of revealing correlations with PISA or significant differences across the groups. Still, they were very consistent in both treatment groups, whereas reductions were not consistently seen in the control group. CONCLUSIONS: 2-[18 F]FDG PET/CT scans did reflect the clinical effects of periodontal treatment very consistently but, for reasons yet to be clarified, less closely than expected.

Neurosensory Deficits of the Mandibular Nerve Following Extraction of Impacted Lower Third Molars-A Retrospective Study.

BACKGROUND: Neurosensory deficits are one of the major complications after impacted lower third molar extraction leading to an impaired patient's quality of life. This study aimed to evaluate the incidence of neurosensory deficits after lower third molar extraction and compare it radiologically to the corresponding position of the inferior alveolar nerve. METHODS: In a retrospective study, all patients who underwent impacted lower third molar extraction between January and December 2019 were compiled. Therefore, clinical data as well as preoperative radiological imaging were assessed. RESULTS: In total, 418 patients who underwent lower third molar extractions (n = 555) were included in this study. Of these, 33 (5.9%) had short-term (i.e., within the initial 7 postoperative days) and 12 (1.3%) long-term (i.e., persisting after 12 months) neurosensory deficits documented. The inferior alveolar nerve position in relation to the tooth roots showed apical position in 27%, buccal position in 30.8%, lingual position in 35.4%, and interradicular position in 6.9%. CONCLUSIONS: A statistically significant increased incidence of neurosensory deficits occurs when the inferior alveolar nerve is directly positioned lingually to the tooth roots (p = 0.01).

Augmented Reality-Guided Apicoectomy Based on Maxillofacial CBCT Scans.

Implementation of augmented reality (AR) image guidance systems using preoperative cone beam computed tomography (CBCT) scans in apicoectomies promises to help surgeons overcome iatrogenic complications associated with this procedure. This study aims to evaluate the intraoperative feasibility and usability of HoloLens 2, an established AR image guidance device, in the context of apicoectomies. Three experienced surgeons carried out four AR-guided apicoectomies each on human cadaver head specimens. Preparation and operating times of each procedure, as well as the subjective usability of HoloLens for AR image guidance in apicoectomies using the System Usability Scale (SUS), were measured. In total, twelve AR-guided apicoectomies on six human cadaver head specimens were performed (n = 12). The average preparation time amounted to 162 (±34) s. The surgical procedure itself took on average 9 (±2) min. There was no statistically significant difference between the three surgeons. Quantification of the usability of HoloLens revealed a mean SUS score of 80.4 (±6.8), indicating an "excellent" usability level. In conclusion, this study implies the suitability, practicality, and simplicity of AR image guidance systems such as the HoloLens in apicoectomies and advocates their routine implementation.

The impact of COVID-19 on oral squamous cell carcinoma's diagnostic stage-A retrospective study.

OBJECTIVE: The COVID-19 pandemic has had an impact on patients' access to primary care services. A timely diagnosis of oral squamosa cell carcinoma is paramount. This study aims to quantify the pandemic's effect on tumor volume at the time of initial diagnosis. MATERIALS AND METHODS: In a retrospective study, all primarily diagnosed cancer patients between March 2018 and March 2022 were compiled; the TNM stage and the tumor volume were evaluated. Tumor volumes were calculated using pathology or radiology reports. RESULTS: In total, 162 newly diagnosed tumor cases were included in this study. Of these, 76 (46.9%) cases were allocated in the "pre-COVID-19" group and 86 (53.1%) in the "COVID-19" group. Patients diagnosed during the "COVID-19" period showed a significantly advanced T stage (p < 0.001) and larger mean tumor volumes (53.16 ± 73.55 cm3 vs. 39.89 ± 102.42 cm3 ; p = 0.002) when compared to the control group. CONCLUSION: Tumor volume and T stage were significantly advanced in the "COVID-19" group when compared to prepandemic data. We hypothesize that the postponement of routine dental check-ups may explain this finding. Hence, dentists and primary care providers are encouraged to place particular emphasis on screening during routine check-ups.

Donor Site Morbidity and Quality of Life after Microvascular Head and Neck Reconstruction with a Chimeric, Thoracodorsal, Perforator-Scapular Flap Based on the Angular Artery (TDAP-Scap-aa Flap).

Extensive defects in the head and neck area often require the use of advanced free flap reconstruction techniques. In this study, the thoracodorsal perforator-scapular free flap technique based on the angular artery (TDAP-Scap-aa flap) was postoperatively evaluated regarding the quality of life and the donor site morbidity using the standardized SF-36 and DASH questionnaires (short form health 36 and disabilities of the arm, shoulder and hand scores). Over a five-year period (2016−2020), 20 selected cases (n = 20) requiring both soft and hard tissue reconstruction were assessed. On average, the harvested microvascular free flaps consisted of 7.8 ± 2.1 cm hard tissue and 86 ± 49.8 cm2 soft tissue components. At the donor site (subscapular region), only a mild morbidity was observed (DASH score: 21.74 ± 7.3 points). When comparing the patients' postoperative quality of life to the established values of the healthy German norm population, the observed SF-36 values were within the upper third (>66%) of these established norm values in almost all quality-of-life subcategories. The mild donor site morbidity and the observed quality of life indicate only a small postoperative impairment when using the TDAP-Scap-aa free flap for the reconstruction of extensive maxillofacial defects.

[Metronidazole - spectrum of activity, use and side effects]. / Metronidazol ­ Wirkungsspektrum, Anwendung und Nebenwirkungen.

This contribution gives an overview of the use, therapeutic effects and side effects of the antibiotic substance Metronidazole. Metronidazole is effective in the treatment support of paradontitis, microbial-caused halitosis, perioral skin infections and odontogenic hard or soft tissue abscess formations related to anaerobic bacterial infections. Due to its anti- parasitic effect, Metronidazole is also effective in the treatment of protozoa. In adults and children from 12 years on, 200 mg Metronidazole to a maximum of 2000 mg Metronidazole per day can be administered. In children below 12 years of age, an antibiotic dose of Metronidazole between 20 to 30 mg per kilogram body weight is advised.